Early Clinical Outcomes Of Different Coronary Artery Bypass Grafting For Surgical Revascularization In Patients With Coronary Artery Disease And Left Ventricular Dysfunction

Objective The aim of our study was to evaluate early clinical outcomes of off-pump,conventional on-pump and on-pump beating-heart coronary artery bypass grafting in patients with coronary artery disease and left ventricular dysfunction,and explored which technique would be more suitable for patients with left ventricular dysfunction.Methods This retrospective study evaluated early clinical outcomes of 133 patients with left ventricular dysfunction(LVEF≤40%)in our Department of Cardiovascular Surgery form January 2014 to December 2017.Patients were divided into three groups on the basis of surgical procedures:68 patients in off-pump coronary artery bypass grafting group(OPCABG group),24 patients in conventional coronary artery bypass grafting group(CCABG group),41 patients in on-pump beating-heart coronary artery bypass grafting group(ONPBH group).Compare the perioperative outcomes and echocardiography before and after surgery of three groups.Result General information Hypertension patients in OPCABG group was more than ONPBH group(P<0.0167).Intra-operative information The operation time of OPCABG group was shorter than CCABG group and ONPBH group(P<0.05).The CPB time of ONPBH group was shorter than CCABG group(P<0.05).The intraoperative transfusion of read blood cell and plasm in OPCABG group was less than CCABG group and ONPBH group(P<0.05).The usage rate of IABP of OPCABG group was less than CCABG group and ONPBH group(P<0.05).Revascularization The number of grafts of ONPBH group was more than OPCABG group and CCABG group(P<0.05).The number of operation which had five grafts of ONPBH group was more than OPCABG group and CCABG group(P<0.0167).Postoperative information The ventilator time and ICU stay time of OPCABG group was shorter than CCABG group and ONPBH group(P<0.05).The drainage of OPCABG group was less than ONPBH group(P<0.05).The postoperative transfusion of read blood cell and plasm in OPCABG group was less than CCABG group and ONPBH group(P<0.05).The echocardiography before and after surgery All of OPCABG,CCABG and ONPBH could benefit the LVEF and LVEDD of patient who had left ventricular dysfunction.Conclusion 1.All of OPCABG,CCABG and ONPBH can benefit the cardiac function of patient who has coronary atherosclerotic heart disease with left ventricular dysfunction.2.OPCABG can shorten the operation time,the ventilator time,the ICU stay time and reduce the drainage and transfusion.3.ONPBH has superior revascularization,but the early outcomes of cardiac function is no different with OPCABG and CCABG.The long-term effects require further follow-up.